Relation between Platelet Count, Oesophageal Varices and Hematemesis /Melena Symptoms in Cirrhotic Patients- A Comparative Study

Abstract

BACKGROUND : Cirrhosis of liver is an end stage of chronic liver disease. This is emerging as an important cause of mortality and morbidity worldwide. Different causes of cirrhosis present with similar clinicopathological features, but their clinical course may be different. Alcohol is a leading cause of cirrhosis followed by viral hepatitis, diabetes and other causes. Complication of cirrhosis occurs either due to development of portal hypertension or impaired hepatic synthetic function or both. Complications include gastro-oesophageal varices, ascites, hepatic encephalopathy (HE), hepato-pulmonary hypertension, hepatocellular carcinoma, hepatorenal syndrome, spontaneous bacterial peritonitis, and coagulation disorders. This study was undertaken to determine the prevalence of thrombocytopenia and oesophageal varices among alcoholic liver cirrhosis patients having hematemesis/melena, and to compare it with non-alcoholic cirrhotic patients. METHODS: Study was done in the Department of General Medicine, Dhiraj Hospital, Piparia, Vadodara. 90 patients detected with cirrhosis of liver were enrolled in this study. A detailed history, physical examination and necessary investigations were done. RESULTS: 35 out of 60 (58.33%) alcoholic patients and 6 out of 30 (20%) non-alcoholic patients had thrombocytopenia. Out of 90 selected patients of cirrhosis of liver, 32 (35.55%) had small while 58 (64.45%) had large oesophageal varices. 40% of those presented with small oesophageal varices had alcoholic liver cirrhosis as underlying cause while 26.67% had non-alcoholic cirrhosis, the difference being statistically significant. CONCLUSION : Prevalence of thrombocytopenia in cirrhosis of liver is very common. Significantly more severe thrombocytopenia is found in alcoholic liver cirrhosis patients. Most of the alcoholic patients developed small varices when compared with non-alcoholic patients. Haemorrhagic episodes were less in alcoholic patients.